Effects of chronic beta-blockade on compensatory mechanisms during acute isovolaemic haemodilution in patients with coronary artery disease

Effects of standardized acute normovolemic hemodilution on intraoperative allogeneic blood transfusion in patients undergoing major maxillofacial surgery

“…The Hb known as ''critical'' for myocardial tissue oxygenation in healthy hearts is 2 g/ dl 15 and 6 g/dl 22 for hearts with compromised coronary perfusion. Moreover, the same degree of dilutional anemia (Hb 10 g/dl) has already been demonstrated to be well tolerated in elderly patients with preexisting coronary artery disease and chronic betaadrenergic receptor blockade 20,21 . While 900 ml (2 units) ANH was found to be practicable and safe in our patients, the question remained whether the collection of a limited ANH-volume of 900 ml would allow for the reduction of allogeneic RBC transfusion.…”

Anemia and perioperative red blood cell transfusion: A matter of tolerance

“…Hemodynamically, there was a significant decrease of pulmonary vascular resistance and pulmonary artery pressure (30 Ϯ 3 vs. 22 Ϯ 2 mm Hg at rest and 59 Ϯ 7 vs. 53 Ϯ 7 mm Hg at maximal exercise, p for both Ͻ.05). In addition, pulmonary gas exchange was significantly improved with PaO 2 increasing from 63 Ϯ 2.4 to 71.8 Ϯ 3.7 mm Hg at rest and from 54.3 Ϯ 5.7 to 64.2 Ϯ 4.5 mm Hg at maximal exercise (p for both Ͻ.05) (49), which has also been observed in patients undergoing ANH (23,24,27). These results further underline the potential benefits of even moderate hemodilution for pulmonary gas exchange and hemodynamics.…”

“…The increase in CO in awake patients is due to an increase both in stroke volume and heart rate (14,18,20,21). In contrast, the increase in CO in anesthetized patients is solely caused by an increase in stroke volume (13,(21)(22)(23)(24). As a consequence, tachycardia in the setting of acute anemia has to be considered as a sign of hypovolemia in anesthetized patients and should therefore primarily be treated with colloids and crystalloids to achieve normovolemia.…”

Impact of Acute Normovolemic Hemodilution in Organ and Cell Structure

“…( Van der Linden et al, 2003). Cardiac output also depends on heart rate which may be affected by drugs such as opioids, which induce vagal stimulation, or -adrenergic antagonists, which impair the expected cardiac response (Clarke et al, 1980;Ickx, 2000;Ragoonanan et al, 2009;Spahn et al, 1997). Even equipotent MACs of different inhalational anesthetics may induce different hemodynamic responses to ANH.…”